PS-239 Early Acute Renal Injury Versus Late Acute Renal Injury. Are There Any Prognostic Differences Between Them?

Abstract

Purpose To evaluate the diagnostic performance and safety of intravesical administration of a-second-generation ultrasound contrast-agent (UCA) for the diagnosis of vesicoureteric reflux (VUR) in children. Methods and materials 1350 children (587 boys/763 girls, mean-age 2.6y, range 15d-17y) with 2720 pelvi-ureter-units, underwent contrast-enhanced voiding urosonography (ceVUS) to rule out VUR and urethral pathology. A second-generation UCA (SonoVue ® , Bracco, Milan) was administered intravesically through 5-8F feeding-tube at a dose of 0.5 ml/bladder filling. Possible adverse-events were monitored during the examination and followed-up for 7 days after the ceVUS by phone-calls. Urine analysis and culture were performed 3-5 d before ceVUS in all children and 24-48 h in any patient reported with adverse-events. Results VUR was detected in 450/1350(33%) patients (162 boys/288 girls). This was in 653 pelvi-ureter-units (reflux-grade distribution: grade I = 1, grade II = 276, grade III = 266, grade IV = 100, grade V = 10). The urethra was normal in all children. Mean duration of examination was 14 ± 7 min, including urethral imaging. Minor adverse-events were reported in 45 (3.3%) children. These included dysuria (n = 39), abdominal pain (n = 2), increased frequency of micturition (n = 1), vomiting (n = 1), perineal irritation (n = 1), and urinary-tract-infection after ceVUS (n = 1). The onset of adverse-events were subacute in 92% and delayed in 8% and were self-limited nonrequiring hospitalisation. Conclusions There were no serious adverse-events with intravesical use of SonoVue ® . Only a few minor adverse-events were reported during ceVUS most likely due to catheterization process. Thus ceVUS with intravesical administration of a second generation UCA (SonoVue ® ) for VUR and urethral pathology detection is a safe and reliable diagnostic procedure in children. Background Idiopathic Hypercalciuria (IH) has been associated with decreased bone density up to 30% of the children. Aims To determine the concentrations of cytokines osteoprotegerin (OPG) and sRANKL and other biochemical indices of bone metabolism in children with IH. Methods In 31 children of median age 6.3 years (range 2.2-16.4) with IH OPG, sRANKL, 25(OH)D, 1,25(OH) 2 D, PTH, Ca, Pi, osteocalcin, ALP and CTx-Crosslaps were determined in serum and Ca/Cr, oxalate/Cr and citrate/Cr in urine. Times of study were at diagnosis and after 3 months of salt free and adequate Ca diet. Height and BMI z-score were assessed. Clinically healthy children (n = 35) matched for age/sex and season were used as controls (median 7.8 years, range 1.8-16.3). Results Although urinary Ca excretion (24 hCa and UCa/UCr) decreased at 3 mo (p < 0.05 and p < 0.01) on average it had not reached control values (p < 0.0001, p = 0.0004). No significant differences were found for urine excretion of citrate and oxalate PS-238 STUDY OF BONE BIOCHEMICAL MARKERS AND THE